Aetna Senior Medical Economics Consultant - Value Based Contracting - 61604BR in Plano, Texas
Req ID: 61604BR
This position is responsible for providing analytical support for Aetna s value based contracts. Candidate will work collaboratively with business units across the Company providing medical cost and outcomes focused analytical research, financial modeling and business decision support reporting. The team is engaged in all aspects of the analytic lifecycle from contract negotiation through reconciliation & settlement, including report development and financial consulting support for provider partners.
Fundamental Components included but are not limited to:
Provide analytical consulting in support of Aetna s value based contracting strategy. Provide analytical support for value based contract negotiations. Provide on-going analytical support for active value based contracts. Perform financial reconciliations as part of value based contracts. Create actionable financial projections, decision support models, and financial reporting for new and evolving products, programs and initiatives. Develop innovative analytics, insights and solutions for medical cost drivers and network design/provider reimbursement issues. Identify medical cost savings opportunities for provider partners to pursue.
Qualifications Requirements and Preferences:
5-8 years demonstrated leadership and project management experience. Ability to manage conflicting priorities and multiple projects concurrently. Strong analytical ability and familiarity with advanced financial and healthcare concepts. Expertise in multiple areas of provider contracting/reimbursement, analysis, modeling & reporting. Extensive & diverse knowledge of healthcare data, metrics & coding structures. Able to make sound decisions to drive solutions.
Information Management - Medical economics, Information Management - Provides analysis and support for planning and forecasting of medical costs, Information Management - Utilizes and maintains pricing models and medical cost tracking tools, Network Management - Contract negotiation
Aetna Application - Enterprise Data Warehouse, Database - Microsoft Access, Desktop Tool - TE Microsoft Excel
General Business - Applying Reasoned Judgment, General Business - Turning Data into Information, Leadership - Collaborating for Results
General Business - Communicating for Impact, General Business - Demonstrating Business and Industry Acumen, Technology - Leveraging Technology
Benefit eligibility may vary by position. Click here to review the benefits associated with this position.
Job Function: Healthcare
Aetna is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected Veterans status.